Psychosocial Therapies: Effective for Menopause Symptoms

Interventions such as mindfulness and cognitive behavioral therapy (CBT) present a promising avenue for addressing mood disturbances, memory lapses, and concentration issues associated with menopause, as per a recent investigation conducted by UCL researchers.

Published in the Journal of Affective Disorders, this study stands as the most contemporary examination of its kind, offering a meta-analysis of 30 studies encompassing 3,501 women undergoing menopause across 14 countries, including the U.K., U.S., Iran, Australia, and China.

Lead author, Professor Aimee Spector (UCL Psychology & Language Sciences), articulated, “Women grapple with a substantial portion of their lives contending with a spectrum of menopausal symptoms, such as hot flashes, shifts in mood, and cognitive fog. These manifestations can profoundly impact the well-being and quality of life of women.”

She further emphasized, “The management of menopause has now emerged as a paramount concern in public health. However, the majority of investigations into menopausal symptom management center on hormonal replacement therapy and physiological symptoms, thus limiting the treatment options for women who harbor reservations about the risks associated with hormone replacement therapy. This oversight also neglects the well-being of women experiencing non-physiological symptoms, such as cognitive fog and mood disturbances, which are exceedingly prevalent.”

The scrutinized studies examined the efficacy of various therapeutic modalities on mood, cognition, and quality of life.

Ten studies probed the effects of CBT-based interventions on menopausal symptoms, while nine focused on Mindfulness-Based Interventions (MBI), and the remaining eleven encompassed Acceptance and Commitment Therapy (ACT), group counseling, marital support, health promotion coaching, and emotional freedom techniques.

CBT-based interventions entailed educating women about the psychological manifestations of menopause, coupled with cognitive and behavioral strategies, relaxation techniques, and symptom monitoring.

On the other hand, MBI-based therapies fostered an emphasis on women’s present experiences and a non-judgmental comprehension of symptoms.

Symptoms were assessed using standardized, internationally recognized self-report instruments, such as the Patient Health Questionnaire PHQ-9 and the GAD7 questionnaire.

The findings revealed statistically significant improvements in anxiety and depression following CBT and MBI compared to no treatment or alternative therapies, translating to modest to moderate changes in daily life.

CBT and group-based psychosocial interventions also proved effective in mitigating memory and concentration difficulties.

All psychosocial interventions demonstrated efficacy in enhancing quality of life, irrespective of their modality.

Regarding the delivery of these interventions, the study suggests that CBT stands as the most cost-effective option for menopause management, necessitating a shorter treatment duration (approximately 1.5 hours per session and 11.8 hours in total) compared to other therapeutic approaches.

Co-author and master’s graduate, Zishi Li (UCL Psychology & Language Sciences), remarked, “This investigation furnishes encouraging evidence supporting the utilization of psychosocial interventions for managing non-physiological menopausal symptoms, aligning with the NICE Menopause guidelines, presently under consultation, which advocate for CBT as a viable treatment option.”

Senior author Dr. Roopal Desai (UCL Psychology & Language Sciences) remarked, “General practitioners and healthcare providers often grapple with the challenge of recommending interventions beyond medical treatments. This research will furnish general practitioners and patients with a broader array of options.”

In November 2023, NICE drafted updated guidelines to incorporate more treatment alternatives for menopausal symptoms, with evidence indicating that CBT could alleviate symptoms such as hot flashes, night sweats, depressive symptoms, and sleep disturbances.

Consequently, the guidelines suggested that CBT should be considered alongside or as an alternative to Hormone Replacement Therapy (HRT).

However, this study represents the first endeavor to explore other forms and dosages of therapy, alongside evaluating the optimal modality for different symptoms.

Experts at UCL have also collaborated with leading women’s health charities to devise a novel education and support program for women across the U.K. grappling with menopause.

Study Limitations:

Due to the lack of individual patient data, the study cannot determine the optimal stage of menopause for intervention delivery.

Additionally, the research cannot account for the long-term changes in symptoms associated with different types of therapy. For instance, some interventions may necessitate prolonged exposure to demonstrate more pronounced effects, while the benefits of others may diminish over time.